Pharmacist Warns My Number Health Card that is Not a Substitute for Medication Notebook

The fact that most medical institutions cannot check medication information from the past month.

“Is it unnecessary to carry a medication notebook if the My Number Card is used as a health insurance card?”

This question has come up in the frequently asked questions regarding the My Number Health Insurance Card, which began full-scale operation in December last year.

The Ministry of Health, Labour and Welfare states that if patients agree to provide their information when registering at medical institutions or pharmacies, doctors and pharmacists will be able to check information such as past prescriptions and specific health checkup results, leading to better healthcare.

On the other hand, the Digital Agency, which has promoted the My Number Health Insurance Card, explains its benefits as follows:

“You can accurately communicate data about the medications you have taken, injections, medical history, and health checkup results, including details from other medical institutions, to doctors and pharmacists. Additionally, even medications prescribed in hospitals, which are not typically recorded in a medication notebook, will be shared accurately.

At pharmacies using electronic prescriptions, pharmacists can check for any drug interactions or duplicate prescriptions based on the latest medication information through the system, allowing for more accurate verification than paper medication notebooks. As a result, patients can take the necessary medications safely and securely.”

After reading this explanation, it’s not surprising that some people may interpret it as meaning that if medication information is accurately shared with doctors and pharmacists, there is no need to carry a medication notebook.

The explanation regarding electronic prescriptions began operations in January 2023. The Ministry of Health, Labour and Welfare (MHLW) points out that medical institutions and pharmacies equipped with electronic prescriptions can accurately confirm the patient’s most recent to the past five years of information through the system.

However, the adoption rate of electronic prescriptions remains low. Of the medical institutions and pharmacies that have introduced the mandatory online eligibility verification system (21,2047 facilities as of January 5 this year), only 22.2% have implemented electronic prescriptions.

Perhaps due to the slow progress in the expected spread of this system, the MHLW recommends carrying an medication notebook in their “Electronic Prescription Q&A” for the public, stating the following:

“Pharmacies and medical institutions that have not adopted electronic prescriptions take about a month to reflect prescribed and dispensed drug information in MyNa Portal. Therefore, in order to track the medications being taken, the medication notebook remains necessary.”

A pharmacist, Satoshi Kitazato (a pseudonym), who works at an emergency hospital in Tokyo, explains:

“Pharmacies and hospitals without electronic prescriptions can only check the patient’s medication information from receipt (medical billing statement). Patients can also view this information on the MyNa portal.

Normally, receipts are updated once a month, on the 11th, after closing on the 10th. This means that hospitals and pharmacies without electronic prescriptions cannot access information on the patient’s most recent medication for the past month.

For example, if a patient visits a local clinic in the morning and another ear, nose, and throat (ENT) clinic in the afternoon, they won’t be able to view the morning’s prescription during the afternoon visit. In the end, the medication notebook is still convenient for confirming medications.”

 

Useful Because It’s Analog! The Role of Paper Medication Book During System Failures and Disasters

The role of the medication booklet is more significant than patients realize, according to Mr. Kitazato.

“There was a case, which was briefly an issue, where a patient was prescribed brand-name medications at one hospital and generic versions at another, leading to confusion because the drug names were different. The patient ended up taking the same ingredient in duplicate.

In another case, a patient who was taking the same type of medication was instructed by the doctor to stop one, but continued with the other, resulting in a surgery delay.

These situations can be prevented by checking the medication booklet.

In the first place, many patients do not accurately know the names of the medications they are taking. Particularly among the elderly, they might know they’re taking blood pressure medicine, but very few remember the name of the medication.

Therefore, I hope patients continue to bring their medication booklet when visiting hospitals and pharmacies as before.”

I asked Mr. Kitazato to list the advantages of the medication notebook.

First, the medication notebook allows you to freely record information such as out-of-pocket medical treatments like vaccinations and over-the-counter drugs purchased at drugstores.

“The data recorded in the system linked to the My Number insurance card is based on receipt information, so the information displayed on My Number Portal is basically limited to insurance-covered medical treatments. Since vaccinations for influenza and shingles are out-of-pocket medical treatments, they do not appear on My Number Portal.

You may think that a medication notebook is only for recording prescribed medications, but you are free to write notes in it. If the name of the vaccine and the date it was administered are written in the medication notebook, it helps medical professionals.

If you take supplements regularly, I recommend writing those down as well. Some supplements can significantly weaken the effects of blood-thinning medications or interact with other drugs, and some need to be discontinued before medical tests or surgery. It might be a good idea to check with your pharmacist when you visit the pharmacy.

There should be a section in your medication notebook to record allergy history, adverse reaction history, and major past illnesses. I recommend filling this out as much as possible.”

A paper medication notebook is also useful in cases of disasters that cause power outages or communication failures.

“Online eligibility verification and electronic prescriptions become useless if system failures occur. In times of disaster, a paper medication notebook is the most reliable option.”

The government aims to introduce electronic prescriptions in almost all medical institutions and pharmacies by March 2025. However, in December last year, a problem occurred where the name of a medication displayed at a pharmacy differed from what the doctor had prescribed. The Ministry of Health, Labor, and Welfare reported seven cases of this issue and requested all medical institutions and pharmacies to inspect their systems. As a result, electronic prescriptions were suspended from December 20 to 26. The issue was apparently caused by medical institutions temporarily using dummy codes to register medications.

“This is something that should never happen. Fortunately, there were no reports of pharmacies dispensing the wrong medications, but it was a serious issue that could have resulted in health damage.

While digitalization is convenient, the current system is still incomplete. Even if your hospital or pharmacy supports electronic prescriptions, for now, it’s safer to continue using your medication notebook as before.”